细胞DNA定量分析技术在尿路上皮癌诊断中的应用价值

Application of DNA-image cytometry in the diagnose of urothelial cell carcinomas

目的:探讨细胞DNA定量分析技术(DNA-ICM)在尿路上皮癌诊断中的应用价值。方法:收集162例尿液标本,其中92例来自尿路上皮癌患者,70例来自良性泌尿系统疾病患者,分别采用DNA-ICM和液基细胞学(LBC)两种方法进行检查,并将两种结果对比。结果:细胞DNA-ICM在尿路上皮癌诊断中的敏感度为65.2%、特异度为100%,LBC分别为27.2%、98.6%,DNA-ICM检查的敏感度高于LBC,差异有统计学意义(P<0.01)。上尿路上皮细胞癌患者尿液标本中DNA-ICM敏感度为77.1%,高于膀胱尿路上皮细胞癌患者尿液标本的57.9%,但两者比较差异无统计学意义(P>0.05)。结论:细胞DNA-ICM在诊断尿路上皮癌方面有较大应用价值,可提高尿脱落细胞学的阳性检出率,是尿路上皮癌诊断和随访的有效检查方法。

Objective To investigate the value of DNA-image cyt-ometry（DNA-ICM） in the diagnosis of urothelial cell carcinomas（UCC）. Methods Totally 162 voided urine specimens（92 cases from urothel-ial carcinomas patients and 70 cases from benign urinary system diseases patients） were detected with DNA-ICM and liquid-based cytology（LBC）, respectively. Results The sensitivity and specificity of DNA-ICM were 65.2%and 100% respectively in the diagnosis of UCC but those of LBC were 27.2% and 98.6%, respectively. The sensitivity of DNA-ICM was significantly higher than that of LBC in the diagnosis of UCC（P 〈0.01）. The sensitivity of DNA-ICM in upper urinary tract urothelial cell carcinomas（UTUC） were 77.1%, which was much higher than that in bladder urothelial cell carcinomas（57.9%） but no statistical significance was found（P〉 0.01）. Conclusion DNA-ICM, which improves the positive rate of urinary cytology, has great application value in the diagnosis of urothelial cell carcinomas and it is an effective screening method for urothelial cancer in diagnosis and follow-up.